NONPHARMACOLOGICAL STRATEGIES FOR MANAGING ANKYLOSING SPONDYLOARTHRITIS

Ankylosing spondyloarthritis (AS) is a chronic inflammatory disease affecting the axial skeleton and peripheral joints, leading to progressive structural and functional impairment with substantial impact on quality of life. Rehabilitation improves functional capacity, reduces pain, enhances the effectiveness of pharmacological therapy, and prevents structural complications. Successful implementation requires patient adherence through education, motivation, active lifestyle promotion, and regular medical supervision. Individualized programs addressing disease-specific features, combined with adequate anti-inflammatory therapy, are essential for maintaining remission. Exercise therapy is fundamental to AS management, with low-intensity activities (walking, cycling, yoga, pilates, swimming) being optimal when axial loading is contraindicated. Supervised exercise programs demonstrate superior outcomes compared to unsupervised home-based approaches. Aerobic exercise improves cardiorespiratory function and reduces cardiovascular risk through inflammation control. Respiratory muscle training significantly enhances pulmonary function in patients with respiratory involvement. Complementary modalities, including spa therapy, can be incorporated based on disease stage and activity. This integrated approach of individualized low-impact exercises with selected physiotherapy interventions holistically improves mobility, psychological well-being, and patient outcomes.